The Diagnosis Of CT-guided Percutaneous Lung Biopsy In Pulmonary Lesions

ForewordWith the development of medical diagnostic imaging technology, the opportunity to find the clinical pulmonary lesions is gradully increasing. The causes of lung lesions are very complexed. sputum alone or with the help of check imaging often can not confirm the diagnosis. X-ray examination can determine the initial lesions, CT and MRI can accurately show the tumor location, size and its relationships with the adjacent tissues, the density and signal through the tumor, indicating that the histological features to help cancer diagnosis, but lack of pathological diagnosis.18FDG PET in the diagnosis and treatment of lung cancer had been broadly utilized, and the same time had been improved the diagnostic level of lung lesions.Bronchoscopy for lung lesions and cavity invading the airway had higher diagnostic value, for central lung cancer can achieve a higher diagnosis rate, but not clear peripheral diagnosis of lung lesions CT-guided percutaneous lung biopsy (Transthoracic core needle biopsy TNB) can not be diagnosed on routine examination of the diagnosis of lung lesions of high sensitivity, CT scan can clearly show the specific location of pulmonary lesions, and lesions density anatomical relationships with the surrounding tissues, the needle can accurately determine the location, angle and depth, safety factor and to improve diagnostic accuracy, especially for small lesions have irreplaceable advantages. According to the literatures, CT-guided percutaneous lung puncture its diagnostic accuracy rate from81.7%to100%. CT-guided percutaneous lung biopsy complications are pneumothorax which is the main complication, hemorrhage, tumor spread and planting, the incidence of pneumothorax reported in the literature from0to61%, subject to the by CT-guided percutaneous lung biopsy success rate, diagnostic accuracy and complications of disease analysis of CT-guided percutaneous needle biopsy of clinical value.PurposeTo Analysis the rate of CT-guided percutaneous lung biopsy, disease diagnostic accuracy and complications of CT-guided percutaneous needle biopsy of lung lesions.To explore the diagnosis value of CT-guided percutaneous lung biopsy in lung lesions. MethodTotal of240cases were include through December2009to December2010. We use the type of Quick-Core10T,20T which needle the biopsy of soft tissue cutting in SEMENS16-slice spiral CT-guided percutaneous lung lesions in patients. Patient adopt supine, lateral or prone position, three-dimensional reconstruction of preoperative patients in the three-dimensional image reconstruction to determine the puncture point, to make the surface mark, measure the angle and the depth of puncture, routine disinfection of shop towels, local anesthesia to the pleura, when patients take short breath-hold the biopsy needle by a predetermined angle and the depth of the,CT scan to confirm once again the target lesion in the tip, the firing ejection system, for tumor biopsy gun along the pipe cutting biopsy, tissue samples will be removed into10%send formalin fixed histopathology, and sent for smear cytology examination and bacterial and fungal culture and acid-fast staining. After pressing the puncture point, and then underwent routine chest CT scanning, puncture with or without pneumothorax, and bleeding complications.Result1. Puncture success rate:240patients were first puncture success, every3to4times a cutting routine biopsy, the lesion stabbed rate of100%.2. Puncture results:inflammatory disease120(50%), cancer disease113cases (47.1%), lung tissue in6cases (2.5%), failed to confirm the diagnosis in1case.3. Complications:pneumothorax in54cases, hemoptysis in22cases, pulmonary hemorrhage in43cases,pleural hematoma in lcase, pneumothorax combined hemoptysis in2cases. All The patients had no serious complications.ConclusionCT-guided percutaneous lung biopsy is very safe, puncture hit rate, positive diagnosis rate and few complications. So it have a great clinical value.